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    Application of vac in type III open fractures
    (Derman Medical Publ, 2018) Atic, Ramazan; Alemdar, Celil; Azboy, Ibrahim; Bulut, Mehmet; Cacan, Mehmet Akif; Gem, Mehmet
    Aim: Functional results of patients with Type III open long bone fractures treated with vacuum-assisted closure (VAC) and approximating sutures were evaluated. Material and Method: A total of 21 patients (4 female, 17 male with a mean age of 27 years, range: 3-64 years) with Gustilo-Andersen Type 3 open fracture were included in the study. The mean follow-up period was 25.67 months (range, 9-52 months). Thirteen patients had Type IIIB and eight patients had Type IIIC open fractures. Following a large debridement and irrigation in an operating room setting, wound dimensions were measured. Subsequently, VAC was applied. During the application, skin traction sutures were applied over the vacuum sponge. During the last dressing change in which a dean granulation tissue was obtained, the wound was closed following the measurement of its dimensions. Wound dimensions measured during the large debridement in the operating room were compared with the wound dimensions measured after the final VAC application. Results: Mean duration between trauma and operation was 7.57 hours (range, 2-23 hours). The wound was closed with delayed primary suturing in seven patients. In the remaining 14 patients, wound dimensions measured following the last VAC application were found to be decreased with a mean of 40.02% (range, 20-60%). Seven patients underwent a skin graft, two had a free flap application, four had a fasciocutaneous flap, and one had a fasciocutaneous flap + graft application. Two patients underwent revision operations for graft failure. Five patients (23.8%) developed a deep wound infection. The infections resulted in osteomyelitis in two patients (9.5%). Discussion; VAC application together with skin traction sutures in Type IIIB and C open fractures decreases wound size dimension of a graft or flap to be applied. Also it may reduce the requirement for secondary interventions.
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    A comparison of percutaneous trephine excision and open surgery in the treatment of osteoid osteoma
    (Springer, 2016) Alemdar, Celil; Cacan, Mehmet Akif; Dusak, Abdurrahim; Ozkul, Emin; Atic, Ramazan; Kapukaya, Ahmet
    Purpose The aim of this study was to compare CT-assisted percutaneous excision, which is a closed, economic method and a more cosmetic approach, and open surgery in the treatment of osteoid osteoma. Materials and methods Fifty-three patients (12 female and 41 male patients) who had percutaneous excision (n = 24) and open surgery (n = 29) were evaluated retrospectively. The mean age was 16.6 years and the mean duration of follow-up was 53.5 months. During percutaneous excision, a trephine was advanced through the labeling wire and the site, including the nidus, was excised en-bloc and the incision walls were curetted. During the open surgery, the localization of the nidus was marked using c-arm X-ray and the nidus was accessed by lifting the cortical bone, layer-by-layer, using burr. The nidus was excised and its cavity curetted. Results The result was successful in 22 and a failure in three patients who had closed excision. The result was successful in 20 and a failure in nine patients who had open surgery. The mean duration of operation was 44.37 minutes in the percutaneous excision group and 80.6 minutes in the open surgery group. There was no difference in the pre-operative VAS values between the two groups, whereas the post-operative VAS values were statistically significantly different. There was also a statistically significant difference in the duration of the operation and the length of the hospital stay between the groups. Conclusion Percutaneous excision with trephine is a more successful, effective, minimally invasive, safe and a better cosmetic approach in the treatment of osteoid osteoma. This method is also a cheap method that does not require expensive equipment.
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    Internet and social media usage of orthopaedic patients: A questionnaire-based survey
    (Baishideng Publishing Group Inc, 2017) Duymus, Tahir Mutlu; Karadeniz, Hilmi; Cacan, Mehmet Akif; Komur, Baran; Demirtas, Abdullah; Zehir, Sinan; Azboy, Ibrahim
    AIM To evaluate social media usage of orthopaedic patients to search for solutions to their health problems. METHODS The study data were collected using face-to-face questionnaire with randomly selected 1890 patients aged over 18 years who had been admitted to the orthopaedic clinics in different cities and provinces across Turkey. The questionnaire consists of a total of 16 questions pertaining to internet and social media usage and demographics of patients, patients' choice of institution for treatment, patient complaints on admission, online hospital and physician ratings, communication between the patient and the physician and its effects. RESULTS It was found that 34.2% (n = 647) of the participants consulted with an orthopaedist using the internet and 48.7% (n = 315) of them preferred websites that allow users to ask questions to a physician. Of all question-askers, 48.5% (n = 314) reported having found the answers helpful. Based on the educational level of the participants, there was a highly significant difference between the rates of asking questions to an orthopaedist using the internet (P = 0.001). The rate of question-asking was significantly lower in patients with an elementary education than that in those with secondary, high school and undergraduate education (P = 0.001) The rate of reporting that the answers given was helpful was significantly higher in participants with an undergraduate degree compared to those who were illiterate, those with primary, elementary or high school education (P = 0.001). It was also found that the usage of the internet for health problems was higher among managers-qualified participants than unemployed-housewives, officers, workers-intermediate staff (P < 0.05). CONCLUSION We concluded that patients have been increasingly using the internet and social media to select a specific physician or to seek solution to their health problems in an effective way. Even though the internet and social media offer beneficial effects for physicians or patients, there is still much obscurity regarding their harms and further studies are warranted for necessary arrangements to be made.